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  1. FHIR Specification Feedback
  2. FHIR-22687

Reference HealthcareService from Slot and Appointment

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • STU3
    • Patient Administration
    • Appointment
      HealthcareService
      Slot
    • Hide

      The following properties will be updated to be a CodeableReference (HealthcareService)

       

      HealthcareService.type will not be updated, and will remain a CodeableConcept.  

      To represent the relationship between a schedulable service and a generic service, we will add a new property:

      HealthcareService.offeredIn 0..*   Reference(HealthcareService)

      Description:  The service within which this service is offered.

      Definition:  When the HealthcareService is representing a specific, schedulable service, the availableIn property can refer to a generic service.

      Comment:  For example, if there is a generic Radiology service that offers CT Scans, MRIs, etc.  You could have HealthcareService resources for the CT Scans and MRIs, which have an offeredIn reference to the Radiology HealthcareService.

       

      We will also update two sections inadministration-module.html to add some narrative:

       

      8.0.2.3 Service Provider Directory Resources 

      <within the table row for HealthcareService>

       

      The details of a healthcare service available at a location or in a catalog.  In the case where there is a hierarchy of services (for example, Lab -> Pathology -> Wound Cultures), this can be represented using a set of linked HealthcareServices.

       

      <the diagram will be updated to include the self reference>

      8.0.2.4 Scheduling and Appointments 

      <under the diagram>

      When the scheduling resources need to identify the specific activity or service that is being scheduled, they may use either a HealthcareService or a coding to represent that activity.

       

      <the diagram will be updated to include the self reference>

       

      The scope and usage of HealthcareService will be updated:

       

      Common examples of HealthcareServices resources are:

      <append>

      CT Head Scan w/o Contrast

      CT Head Scan with Contrast

      CT Head+Chest Scan with Contrast

       

      Example uses of HealthcareService resources are:

      • National Services Directory - Consumer Focus
      • National Services Directory - Practitioner Referrals Searching
      • Organization's Client Portal - to locate services / book appointments
      • Address book of services for Referrals
        including references to Questionnaires for assessments that are required as part of the referral
      • Health Network internal directory Used for tracking available services offered internally, and also those offered by business partners.
        This information may also include costing information.
      • Catalog of schedulable services or activities

       

       

      Show
      The following properties will be updated to be a CodeableReference (HealthcareService) Appointment.serviceType   Slot.serviceType Encounter.serviceType Schedule.serviceType   HealthcareService.type  will not  be updated, and will remain a CodeableConcept.   To represent the relationship between a schedulable service and a generic service, we will add a new property: HealthcareService.offeredIn  0..*   Reference(HealthcareService) Description :  The service within which this service is offered. Definition :  When the HealthcareService is representing a specific, schedulable service, the availableIn property can refer to a generic service. Comment :  For example, if there is a generic Radiology service that offers CT Scans, MRIs, etc.  You could have HealthcareService resources for the CT Scans and MRIs, which have an offeredIn reference to the Radiology HealthcareService.   We will also update two sections inadministration-module.html to add some narrative:   8.0.2.3 Service Provider Directory Resources  <within the table row for HealthcareService>   The details of a healthcare service available at a location or in a catalog.  In the case where there is a hierarchy of services (for example, Lab -> Pathology -> Wound Cultures), this can be represented using a set of linked HealthcareServices.   <the diagram will be updated to include the self reference> 8.0.2.4 Scheduling and Appointments  <under the diagram> When the scheduling resources need to identify the specific activity or service that is being scheduled, they may use either a HealthcareService or a coding to represent that activity.   <the diagram will be updated to include the self reference>   The scope and usage of HealthcareService will be updated:   Common examples of HealthcareServices resources are: <append> CT Head Scan w/o Contrast CT Head Scan with Contrast CT Head+Chest Scan with Contrast   Example uses of HealthcareService resources are: National Services Directory - Consumer Focus National Services Directory - Practitioner Referrals Searching Organization's Client Portal - to locate services / book appointments Address book of services for Referrals including references to Questionnaires for assessments that are required as part of the referral Health Network internal directory  Used for tracking available services offered internally, and also those offered by business partners. This information may also include costing information. Catalog of schedulable services or activities    
    • Brian Postlethwaite / Sonja Ziegler : 5-0-0
    • Enhancement
    • Non-compatible
    • R5

    Description

      I have been looking into the overall scheduling domain (both traditional OP appointments and surgeries).

      I think the core resources make up a really robust model:\\Schedule\\Slot
      Appointment

      When we look at a Slot, it is important to know what type of "service" is provided during that slot. This is supported like this:
      "serviceType 0..* CodeableConcept The type of appointments that can be booked into this slot (ideally this would be an identifiable service - which is at a location, rather than the location itself). If provided then this overrides the value provided on the availability resource"

      Question/Suggestion
      Wouldn't it be better to instead from Slot reference a HealthcareService? HealthcareService is in itself defined as "The details of a healthcare service available at a location." which also matches the description of the Slot's serviceType element.

      This would also bring other benefits, such as specifying resource requirements for a service (this slot needs a certain staff type, equipment and/or room) which would then be attributes on the HealthcareService.

      Initially I looked into this from a Slot<-->HealthcareService perspective, but I can see that we should do the same thing from Appointment (allow possibility to reference a HealthcareService instead). This makes a complete solution for the core parts of creating a repository of services (HealthcareService), schedule capacity to provide the services (Slot), plan appointments for a certain service (Appointment for a HealthcareService) and then finally match the appointment into a corresponding slot for the correct service.

      This has alos been discussed in this Zulip chat:

      https://chat.fhir.org/#narrow/stream/179166-implementers/topic/HealthcareService.20and.20Slot

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            brian.postlethwaite Brian Postlethwaite
            martingrundberg Martin Grundberg
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              Updated:
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